Post-Traumatic Stress in Soldiers ‘Increases Risk of Heart Attacks’ Link Confirmed By Study of US Veterans of Vietnam War

August 22, 2008

By IAN BRUCE DEFENCE CORRESPONDENT

MILITARY veterans suffering from post-traumatic stress disorder are more than twice as likely to die prematurely from heart attacks than soldiers who have not been exposed to psychological damage as a result of military service, according to a major new US study.

The evidence linking PTSD with cardiovascular disease was inconclusive until now, but research that followed 4500 US Vietnam veterans over a 15-year period confirms that mental trauma is a major cause of heart disease, according to Dr Joseph Boscarino from the Centre for Health Research in Pennsylvania, who led the project.

Dr Boscarino said the physical effect of repeated exposure to the horrors of the battlefield equated to smoking two to three packs of cigarettes per day for more than 20 years.

None of those involved in the study suffered from heart disease when the project began, but were monitored regularly over 15 years. All were younger than 65 when the final examinations took place.

After screening out key factors that might influence the results, Dr Boscarino found that PTSD was associated with a greater than twofold increased risk of death from heart disease in these soldiers.

“Men in the study, on average, were in their mid-50s when it began. Yet they were developing heart disease from PTSD and dying too early, ” he said.

PTSD causes the body to release stress hormones, which leads to inflammation and damage to the arteries and cardiovascular system. Stress hormones also tend to reduce the amount of cortisol in the body, a hormone that fights inflammation.

“The science is conclusively showing that if you suffer psychological trauma, it’s going to take a toll on your physical health, ” Dr Boscarino added. “Getting counselling today is critical to avoiding a related problem tomorrow. Doctors should be aware of PTSD as a risk factor for heart disease, just like they are for smoking, cholesterol and other contributory factors.”

Publication of the findings follows a warning two months ago by Thomas Insel, head of the US National Institute of Mental Health, that suicides and “psychological mortality” among US troops who served in Iraq and Afghanistan could exceed battlefield deaths if their mental scars were left untreated.

Of the 1.6 million US troops who have been deployed in Iraq and Afghanistan, 18-20per cent – or around 300,000 – show symptoms of post-traumatic stress disorder (PTSD), depression or both, according to Dr Insel.

An estimated 70per cent of those at-risk soldiers do not seek help from the US Department of Defence or the Veterans Administration.

Left untreated, PTSD and depression can lead to substance abuse, alcoholism or other life-threatening behaviours. Figures released by the Ministry of Defence last year showed that almost 1900 British troops who had served in Iraq or Afghanistan had been diagnosed with mental health problems ranging from PTSD to mood disorders.

Colonel Clive Fairweather, former deputy commander of the SAS and chief fund-raiser for the mental health charity Combat Stress in Scotland, said: “It used to take between 12 and 14 years for the symptoms of PTSD to show. Now we’re seeing victims two years after the events which triggered their problems.”